Department of Internal Medicine, St Elizabeth Health Center, 1044 Belmont Avenue, Youngstown, OH 44501, USA.
Hepatobiliary Pancreat Dis Int. 2013 Aug;12(4):440-2. doi: 10.1016/s1499-3872(13)60069-7.
Hepatic abscess secondary to Salmonella is extremely rare in the United States and other Western countries.
A 43-year-old Caucasian man, with a history of chronic alcohol abuse, was admitted to the hospital for intermittent abdominal pain, fever and diarrhea. Clinical, radiological and laboratory results were analyzed. Medical literature in PubMed pertaining to similar cases was reviewed.
Stool culture was positive for Salmonella serotype B and a CT scan of the abdomen with contrast was consistent with a solitary hepatic abscess. Appropriate intravenous antibiotics followed by oral maintenance therapy for six weeks resulted in a complete clinical recovery and radiographic resolution.
The cause of Salmonella hepatic abscess in our patient was most likely associated with decreased mucosal resistance to the bacteria, seeding of infection via transient portal bacteremia and loss of host immunity. Our case highlights the fact that appropriate antibiotic alone is sufficient in the management of a solitary hepatic abscess less than 3-5 cm.
在美国和其他西方国家,由沙门氏菌引起的肝脓肿极为罕见。
一名 43 岁的白人男性,有慢性酗酒史,因间歇性腹痛、发热和腹泻住院。对临床、影像学和实验室结果进行了分析。并查阅了 PubMed 中有关类似病例的医学文献。
粪便培养出肠炎沙门氏菌,腹部 CT 扫描加对比剂检查提示单发肝脓肿。给予适当的静脉用抗生素,随后口服维持治疗 6 周后,患者完全康复,影像学检查结果也恢复正常。
我们的患者发生沙门氏菌肝脓肿的原因很可能与黏膜对细菌的抵抗力下降、短暂性门静脉菌血症导致的感染播散以及宿主免疫丧失有关。我们的病例强调了一个事实,即对于直径小于 3-5 厘米的单发肝脓肿,单独使用适当的抗生素治疗就足够了。